Lineamientos técnicos para el manejo y disposición final de cadáveres de casos COVID-19 (Segunda Edición) / Technical guidelines for the management and final disposal of cadavers of COVID-19 cases (Second Edition)

Las directrices para el manejo y disposición final de cadáveres por COVID­2019, requieren de medidas de bioseguridad y precaución estándar encaminadas para este fin y lograr la prevención de esta infección en el personal responsable del manejo y disposición final de cadáveres. Los presentes lineamientos técnicos contienen las actividades que el personal de salud debe cumplir para el manejo y disposición final de cadáveres en los diferentes escenarios y durante el traslado en busca de atención. Asimismo se establecen las indicaciones para la inhumación ante el fallecimiento por caso confirmado o sospecho de COVID-19. Todo lo anterior con el objetivo de proteger la salud de la población en general fortaleciendo la prevención y evitando la transmisibilidad. Objetivo general: Establecer las disposiciones técnicas y de bioseguridad para la prevención de infecciones en el personal responsable del manejo y disposición final de cadáveres por COVID­19, familiares, comunidad en general y otros actores que intervengan en estos procesos por mandato legal. Objetivos específicos: a)Brindar las directrices sobre el manejo y disposición final del cadáver dentro y fuera de los establecimientos de salud. b)Orientar a las instituciones funerarias sobre el procedimiento a seguir durante la pandemia COVID-19. c)Disponer de un instrumento legal que garantice evitar la transmisibilidad de la enfermedad COVID-19 por la manipulación de cadáveres. Ámbito de aplicación: Están sujetos al cumplimiento de los presentes Lineamientos técnicos el personal del Sistema Nacional Integrado de Salud, municipalidades, personas naturales y jurídicas que estén vinculadas al manejo y disposición final de cadáveres por COVID-19

Exhumation and identification: A case report.

The term exhumation is restricted to legally digging out the body from the grave after burial. The objectives of disinterment can vary in various cultures as well as countries and requirements vary from place to place However, most cases of exhumation occur because there is a request from a magistrate to carry out an autopsy to gain essential forensic evidence. The paper discusses such a case of 10 year old girl who was buried after committing sexual assault and strangulation. After the passage of about two years the victim’s body was retrieved from the place identified by the accused persons who confessed to the crime. The body of the victim was identified by her mother from a small piece of under slip and other articles she was wearing. The paper discusses various aspects of exhumation and also stresses the importance of careful examination and recording of personal articles, belongings etc of the victim recovered from/with the body during autopsy examination.

Observation of sex chromatin in exhumed bones, evaluation of their diagnosis value / Observación de la cromatina sexual en osamentas exhumadas, evaluación de su valor diagnóstico

Observation of sexual chromatin has shown to be very helpful in gender forensic diagnosis. In the present study we analyzed the diagnosis performance of the method in, non-treated or treated with conventional bone techniques, exhumed bone pieces. We used long bones of male and female individuals, the method applied is described in Suazo et al. (2010). In the non-treated exhumed pieces, the general accuracy of the method was 75 percent, while in the treated pieces the method was inapplicable due to the lack of cells in the tissue. Our results suggest that it is possible to determine the sex of aged human bones buried under different conditions through a fast and simple histological method, but the treatment with physical and chemical means eliminates the remaining cells in the bone tissue.

La observación de la cromatina sexual ha demostrado ser útil en el diagnóstico forense del sexo. En este estudio analizamos el rendimiento diagnóstico del método en piezas óseas exhumadas no tratadas y tratadas mediante osteotécnica convencional. Utilizamos muestras de huesos largos de individuos de sexo masculino y femenino, el método se aplicó de acuerdo a lo descrito por Suazo et al., (2010). En las piezas exhumadas no tratadas la exactitud general del método fue del 75 por ciento, mientras que en las piezas tratadas el método resultó inaplicable, debido a la ausencia de células en el tejido. Nuestros resultados sugieren que es posible determinar el sexo en osamentas humanas exhumadas de larga data y en diferentes condiciones de enterramiento, mediante un método histológico rápido y sencillo, pero que el tratamiento por medios físicos y químicos elimina las células remanentes en el tejido óseo.

Exhumation: A 10-year retrospective study.

Exhumation is done for number of reason and includes establishment of identity, to know cause and manner of death, belated suspicion of an unnatural death or for medical insurance problems. It is infrequently done in India and due to cultural practice of cremation by burning to ashes the data are lacking. Compared with conventional autopsy done immediately after death, exhumation poses many problems. The present study was aimed to collect data regarding exhumation, to collect morphological findings in comparison with maximum postmortem interval and to analyze them in an attempt to formulate “catalogue of expectation” to supplement the published literature. Total 24 forensic exhumations performed at three centers of this region from 1999 to 2008 were evaluated retrospectively. Total 24 cases were analyzed and amongst them 12 were men and 12 were women and their age ranged from 3 years to 75 years (mean age 26.95). In the present series, the cause of death at exhumation could be clearly determined in 16 cases (66.6%). Amongst others, the burial practice and postmortem interval are major determining factors for possible outcome at exhumation.

The Deceased's Body Destroyed in Exhumation of Clandestine Graves: Case Reports and Literature Review / 대한법의학회지

Exhumation in clandestine graves has to be done very carefully, since it is considered as a crime scene. Most such cases are related to a suspicious death and it is very important to search for human remains carefully. Before excavation, all operational procedures have to be planned in advance. Missing evidence or human errors can be avoided if each investigative team member works together with archaeological assistance and forensic pathologists. But in practice, it may be difficult to work according to established standard operational procedures because, in many cases, the clandestinely buried victims appear in unexpected areas or it is hard to locate the exact location of the site. Therefore, we present the following cases and hope that the general principles for exhuming a clandestine grave will be established so that they can be helpful in similar investigations in the future.

Victim of adultery with bigotry.

A classical case in which the victim was killed in a bizarre manner, by his own (two) wives and their boyfriend. For the past 8 years victim had been living in the city for livelihood while he left the family in the village. In his absence both the wives who are sisters developed an illicit relationship with a man from the same village. The victim unexpectedly visited the village on the occasion of Ganesh Chaturthi and came to know about their illicit relationship. He put-up the issue in the panchayat which enraged both the wives and their paramour hence they planned to kill him. In the name of a get-together they got the husband drunk and once unconscious, they beat him mercilessly and strangled him to death. They packed the body in a gunny bag, wrapped it in a woolen blanket and buried him in a partially dried pond in the outskirts of the village. Due to the sudden disappearance of the victim the relatives suspecting foul play, informed the police. During interrogation by the Police the wives and their paramour confessed their crime.

Exhumation -a key to provide justice to victims of homicide: situation in Larkana and Sukkur divisions

Foul play in cases of hurt and homicide is an established fact. People on basis of enmity falsely charge their enemies; this practice is carried out globally. The purpose of present study was to know the situation in the study area and also to know the risk factors which make hindrance in providing justice in exhumed cases. The present study was conducted over a period of 3 and half years from Jul 2006 to Dec 2009. During the said period total 21 exhumations were carried out in Sukkur and Larkana Divisions by the team of Chandka Medical College, Larkana. Cases were studied in Forensic Medicine Department of Chandka Medical College, Larkana. Out of 21 cases, only 9 cases were positive [autopsy]. In rest of 12 cases, autopsy reports remained undetermined due to advanced decomposition/putrefaction of corpses. During the study period, total 21 exhumations [autopsies] were carried out in different districts of Larkana and Sukkur divisions. There were 17 male cases and 4 female cases. Cases were divided in to 4 groups on age basis. Group-1 from 0-5 years, Group-2 from 16-30 years, Group-3 from 31-45 years, Group-4 from 46-65 years. The maximum number of cases fall in group-2 which are 15 [71.42%] and minimum in group-1 which is 1 [4.76%]. Out of 21 cases, only in 9 cases cause of death was ascertained and majority of these were firearm injuries [5, 55.55%], two [22.22%] cases of drowning, one [11.11%] strangulation and one blunt trauma. The success rate remained 42.85%. Nineteen cases were of primary autopsy [First time] on exhumation and 2 cases were secondary [re-examination]. The success rate in challenge cases depends mostly on the duration of exhumation and soil of cemetery. If a foul play is suspected then there should be no unnecessary delay in conduction of exhumation. If exhumation is carried out within days after burial, 90% results can be achieved

Gastroenteritis exhumed

Nature of presenting symptoms and even signs of disease can lead to a diagnosis that seems routine but is in fact erroneous because a sufficient index of suspicion is not generated in the mind of the physician dealing with the case. A young girl of about 16 years was brought to the Casualty Department, DHQ Hospital Bannu on 12 Sep 2004 with complains of severe vomiting and diarrhoea; the casualty medical officer diagnosed her as a case of acute gastroenteritis

Medicolegal Reconstruction of the Jeju 4.3 massacre / 대한법의학회지

Sixty years after the massacre took place at Jeju, authors carried out a series of exhumations. The exhumation based on anthropological and archaeological method allowed for the interpretation of events occurring during the burial of the body and provided data for crime scene investigation, the evidence.

Adaptation of archaeological techniques in forensic mass grave exhumation: the experience of 'Chemmani' excavation in northern Sri Lanka.

There have been several mass grave excavations in Sri Lanka during the period of 1995 to 1998. Excavation of mass graves in the Chemmani area of northern peninsula of the country took place in September 1999, after about 5 years of the incident. Six graves with 1 to 6 bodies in each were identified and excavated in accordance with archaeological methods modified to suit the requirements of forensic exhumations. The experience gathered from excavation of those sites revealed the importance of archaeological methods in mass grave exhumations. For the first time in our forensic history, services of archaeologists and soil experts were used in the Chemmani exhumation. Their knowledge was found useful in locating the pit, pedestalling, and collection of human remains without causing any damage and artefacts, and in recording of the data.

Individual Identification of Human Remains from the Korean War / 대한법의학회지

During the exhumation of victims of Korean War, among the memorial activities of Korean War, we found a dead body in a tomb in Kyung-Ju city. With the testimony of natives we could find the family related with the body. Using bone and teeth of it we determined that it was male and about 20 years old or more and the result was unite with the insistence of the bereaved family. With the photography offered by the family and the skull we did the photographic superimposition and according to the result we could not exclude that it was the same person with him. We performed mitochondrial DNA(mtDNA) sequencing and it reveals that the dead body and the family have same maternal inherited mtDNA. Finally, We could identify the dead body. At present it is very difficult thing to collect much data of victims of Korean War because it passed over 50 years. But if we find the bereaved family of them we can identify them more accurate and more objective with the forensic identification method like sex determination, age estimation, superimposition and mtDNA sequencing and so on.